A QUICK TOUR OF YOUR COVER

Transcription

1 VISITORS & WORKING VISA HEALTH INSURANCE A QUICK TOUR OF YOUR COVER THIS BROCHURE APPLIES TO WORKING VISA HEALTH INSURANCE AND VISITORS HEALTH INSURANCE. A QUICK TOUR OF YOUR COVER 1

2 Your guide to getting started Welcome and thank you for choosing Medibank. As one of Australia s largest private health funds, we not only give you peace of mind, but we also offer many other benefits including: access to a national retail network access to Mi Health, a range of health support services ability to manage your membership online great benefits with our Members Choice network Plus many more. But right now, we want to help you get the most out of your health cover. In this brochure you ll find a variety of useful information, so remember to keep it handy and use it along the way. If you find you re not entirely satisfied with the cover you ve chosen, let us know within 30 days of joining or changing your cover, and you can either change to a more suitable cover or we can refund your premium in full, as long as no claims have been made against your policy. If you close your membership after the cooling off period, we ll refund any unused premium less an administration fee. You should read this document in conjunction with your Membership guide and Cover summary. If you have Visitors Health Insurance or Working Visa Health Insurance, this brochure is for you! A QUICK TOUR OF YOUR COVER 2

3 What s inside Using your cover 4 Making a claim 5 Out-of-pocket expenses 6 Reducing your out-of-pocket expenses 6 What if your needs change? 7 Mi Health 8 Managing your membership online 10 More than just health cover 10 Medibank and the community 11 A QUICK TOUR OF YOUR COVER 3

4 Using your cover Before you go to hospital or receive treatment for extras services, it s important to check with us to see: if your level of cover includes the services you require whether you ve served all your relevant waiting periods whether any excess applies to your hospital cover (if applicable, you ll need to pay your excess on admission or before being discharged from hospital) what benefits you can expect to receive. Going to hospital Choosing your specialist You can choose your specialist and hospital where available. Often your GP will refer you to a specialist if you need treatment in hospital or day surgery. Prior to treatment your specialist should obtain Informed Financial Consent from you. This is usually in the form of a written document outlining the out-ofpocket expenses that you may have including the cost of any surgically implanted prostheses and other items associated with your treatment. You should sign this document prior to treatment to show that you have been told about the costs and that you accept them. Choosing your hospital If possible, make sure you are treated at a Members Choice hospital where our agreement with the hospital limits what you can be charged. If you go to a Non Members Choice hospital, you re likely to have significant out-of-pocket expenses. Using your extras You could help reduce your out-of-pocket expenses if you take advantage of the agreed prices and discounts we ve negotiated with our Members Choice extras providers. Plus, you ll get a percentage back of the charge depending on your level of cover. You ll receive a fixed benefit when you visit a Non Members Choice provider. A fixed benefit is the maximum amount we ll pay for each service or item (up to applicable limits). Using your medical cover When you receive medical treatment from a doctor, either in or out of hospital, Medibank may pay benefits equivalent to, or above, the Medicare Benefits Schedule (MBS) * fee, depending on your level of cover. You will have to pay any additional cost if the doctor charges more than the benefits we pay you. Please note Medibank does not pay benefits for services not listed under the MBS. * This schedule lists all the services for which Medicare pays benefits and the rules that apply to the payment of those benefits. To find a Members Choice provider use our mobile app medibank.com.au/mobile, visit medibank.com.au or call A QUICK TOUR OF YOUR COVER 4

5 Making a claim There are a number of ways you can claim with Medibank. On-the-spot for most extras services You can use your Medibank membership card to make a claim on-the-spot at extras providers with electronic claiming facilities. This way, your claim will be processed immediately and you only pay the difference between our benefit and the provider s charge. Online for most extras services & doctors claims (GPs only) You can also claim most extras services and GP claims through our Online Member Services at medibank.com.au If a benefit is payable we ll process your claim and depending on your preference, we ll either send out a cheque or transfer the money into your nominated bank account. In person at a Medibank store Please attach your account and receipt to a claim form and drop it off at a Medibank store. Once your claim is processed, any payments will be made directly into the bank account registered to your membership, or by cheque. By mail Simply complete, sign and send a claim form to us: Hospital claims Medibank Private, GPO Box 9999, in your capital city Medical and Extras claims: Medibank Private Medical and Extras claims, GPO Box 2984, Melbourne VIC 3001 Make sure you attach your service provider s account and the receipt (if the account has been paid). You can get a claim form online at medibank.com.au or by calling us on Accident incident form If you wish to make a claim as a result of an accident, you ll need to complete an Incident form. This helps us assess your claim and to determine if a benefit is payable. You can get a copy of the form online at medibank.com.au or by calling us on Alternatively, once you ve submitted your claim, we ll post one out to you. When you ve been to hospital, in most cases, the hospital will bill us directly for the hospital charges. But, you may still receive other bills such as doctors bills. Please also refer to your Membership guide for more information about how to claim. A QUICK TOUR OF YOUR COVER 5

6 Out-of-pocket expenses Out-of-pocket expenses are costs that can occur for a number of reasons. In some cases they are related to the type of cover you have purchased, for example, if your cover has an excess for hospital admissions. Other out-of-pocket expenses occur where there is a difference between what the doctor, specialist or extras provider charges and the total benefit you receive from Medibank. Before you go to hospital call us first on so we can help you understand any out-of-pocket expenses you may incur and the types of questions you need to ask your doctor or specialist. Reducing your out-of-pocket expenses Great benefits with our Members Choice network Medibank has entered into special agreements with most private hospitals and many extras providers across Australia. Currently, Members Choice extras providers include dentists, dental prosthetists, optical retail outlets, physiotherapists, chiropractors, naturopaths, podiatrists, acupuncturists and remedial massage therapists. If you re on our Top 85 Working Visa Health cover you ll have certainty knowing you ll get back * 85% of the charge *, whenever you visit a Members Choice provider. Also, in most instances you will receive higher benefits than if you were treated by a Non Members Choice provider. Ensure you are treated at a Members Choice hospital where our agreement with the hospital limits what you can be charged and reduce any out-of-pockets. If you go to a Non Members Choice hospital, the hospital may charge out-of-pocket expenses that may be significant. * For eligible services up to applicable limits. A QUICK TOUR OF YOUR COVER 6

7 What if your needs change? Life is full of surprises and you never know what s around the next corner. But, no matter what turn your life takes, we ll be there with you every step of the way. Health cover reviews From time to time you should review your needs and plan for the road ahead. If your needs do change, please contact us and review your cover. It s a sure way to ensure you get the right cover, and great value, at every stage of your life. Suspending your membership Planning to get away for a while? Don t forget that your private health insurance will not cover you outside Australia. While you re travelling outside of Australia, you can apply to suspend your cover for anywhere between 2-4 months and pay no premiums for this period you re away. Six months is required between suspension periods. Having a baby? It s easy to make sure your new addition is covered. If you re on a family membership You can add a baby to your membership at any time after the birth. Your child will be covered from their date of birth, or, in the case of adoption or fostering, the date of inclusion in your family unit. This means they won t need to serve any waiting periods already served by the membership. If you re on a single or couple membership You can add your child to your membership, however this will change it from a single or couple to a family membership. If you do this within two months from the date of their birth or inclusion in your family unit (for example, through marriage, adoption or fostering) your child won t have to serve any additional waiting periods. However the change will be backdated to their date of birth or the date of inclusion in your family unit. Also, this change of membership may mean you ll need to pay higher premiums. Keeping your kids covered as they grow up If your children are studying full time, they can remain on your membership until they re 25 so long as they re not married or in a de facto relationship. No excess for kids If your child is admitted to hospital and you have an excess included on your Family hospital cover, you won t have to pay this amount. Please note any other out-of-pocket expenses which may be payable under your cover will still apply. Your premium doesn t increase when you add a dependent child to your cover. A QUICK TOUR OF YOUR COVER 7

8 Mi Health Mi Health provides health support services, designed to help our members manage their health and lifestyle. As a member with hospital cover, you ll have access to the Mi Health support services. It s our commitment to making health cover better for our members. 24/7 Health Advice Line with a Medibank nurse You can call the 24/7 Health Advice Line with any health question you and your family may have, 24 hours a day, seven days a week. Designed to complement the care given by general practitioners and other health professionals, Medibank nurses can give you advice about your health, symptoms, diagnosed conditions and discuss treatment options. They can also help you find medical centres, child health services, dentists, mental health services, pharmacies and more. If you call with a health problem that our nurses believe should be seen by a doctor promptly, they ll offer to ring your regular GP and help you make an appointment. Translators for a range of languages are available if required. Members can access the Medibank nurse by calling 1800 Mi Health ( ). A QUICK TOUR OF YOUR COVER 8

9 Hospital Support Hospital Support provides you with personal advice and support about your overnight hospital stay. Call for more information (or for corporate cover). Mobile Health Apps Access our health apps on your mobile phone when you need health information on the go. Symptom Checker* Check your everyday symptoms, find out what to do about them including when to seek professional treatment. * Only available on iphone. iphone is a trademark of Apple Inc. Energy Balancer To help you balance the foods you re eating with exercise and activities. The Mi Health services are provided by Medibank Private Limited and its related companies. For details on how your personal (including sensitive) information is handled see the back cover of this brochure. A QUICK TOUR OF YOUR COVER 9

10 Managing your membership online Medibank Online Member Services is a convenient way of managing your membership online. You can submit claims, make payments and access health programs 24/7. By logging into Online Member Services you can make the most of your membership. You ll be able to: claim for most extras claims and view your claiming history make a doctor s claim (GPs only) pay premiums change payment type view payment details view membership details download brochures and forms order a replacement membership card request to suspend membership update your contact details register your bank account details for payment of claims (via EFT) send secure mail to Medibank; and access Medibank s online Health Hub (see page 8 for more information). More than just health cover As a member, you get a 10% discount on the following products: pet insurance For more information visit medibank.com.au Exclusive flybuys rewards for Medibank members We think our members should be rewarded for taking care of their health. That s why you can benefit from TRIPLE POINTS * when buying fresh fruit and veg and frozen veg^ at Coles plus earn points when you pay your Medibank premium. All you need to do is link your memberships. To find out more about this offer and applicable conditions, visit medibank.com.au/flybuys * TRIPLE POINTS offer is limited to 1,000 additional points per month on fresh fruit and veg and frozen veg. ^ Nuts and some other exclusions apply see flybuys.com.au/medibank for details. Getting started You can register for Online Member Services at To login visit Note: All current Medibank Private members aged 16 years and over can use Online Member Services. If you re the Policy Holder you ll have access to all the features under your cover type. Access to some functions may be limited for your partner and dependants. A QUICK TOUR OF YOUR COVER 10

11 Medibank and the community Medibank is very much a part of the communities in which we operate. We have a proud record of contribution to community initiatives and, through our Community program, we provide employees with the opportunity to be involved in, and contribute to, their local community through volunteering, gift matching and workplace giving. The Medibank Community Fund (MCF) complements these activities, with a focus on healthy living. The Fund aims to support initiatives that enable people to live longer in good health, staying mentally and physically active by encouraging physical activity, healthy eating and community connectedness. To achieve this, the Fund has been designed around three programs: flagship community partnerships; community grants; and scholarship study grants. A QUICK TOUR OF YOUR COVER 11

12 (if calling from outside Australia) medibank.com.au In store Medibank Private is a signatory to the Private Health Insurance Code of Conduct. The Private Health Insurance Code of Conduct logo is a trademark of, and is used under authorisation from, Private Healthcare Australia. The information contained in this brochure is current at the time of issue, May 2015, and supersedes all previously published material. It only applies to Medibank branded products. Medibank Private Limited ABN Effective May MPL A QUICK TOUR OF YOUR COVER 12